Study finds throat infections caused by gonorrhoea on the rise

By
Amanda Hoh

Men living in Sydney’s south-east have experienced a four-fold increase in throat infections caused by gonorrhoea, a new study has found.

Men living in Sydney’s eastern and southern suburbs have experienced a four-fold increase in throat infections caused by gonorrhoea, a new study has found.

From January 1, 2010 to December 31, 2012, the study found that out of 3132 reported cases of gonorrhoea, 88.3 per cent of the cases were men.

In 2010, there were 87 reported cases of throat infections, which increased to 352 cases in 2012.

There was also a 78.8 per cent increase in anorectal infections, from 236 cases in 2010, versus 422 in 2012.

“We presume they’re largely men who have sex with men,” study co-author and Director of South Eastern Sydney Public Health Unit, Professor Mark Ferson, said.

“If people are having oral sex, then I think one of the important points is that different sorts of sex will all allow transmission of sexually transmitted infections (STI) and it’s important to use condoms or other barrier methods to minimise the spread of gonorrhoea and other infections like syphilis and chlamydia.”

The study, published in the Medical Journal of Australia, used the NSW Health’s notifiable diseases database to link multiple infection cases with individual patients living in Sydney’s eastern and southern suburbs, and central Sydney areas including the CBD, Woolloomooloo, Potts Point, Darlinghurst and Surry Hills.

The study noted that south-eastern Sydney had the largest concentration of gay men, and in whom there has been a high rate of infectious syphilis, though the rate of syphilis had stabilised since an increase of occurrence from 2001, Professor Ferson said.

Over 11 per cent of men in the study, had more than one episode of gonorrhoea infection in the three-year period, while nearly 35 per cent of the men, had two or more episodes of any STI in the same period.

The study also found it was common for men to be co-infected with chlamydia when they tested for gonorrhoea. Professor Ferson said their findings indicated that doctors need to take throat swabs from patients, in addition to genital and anal swabs, when the person is suspected of having gonorrhoea.

While the infection can be treated with antibiotics, a patient can be reinfected again with a new partner if safe sex isn’t practiced.

“Because it is this part of Sydney, it’s not really surprising but we would like it to be lower,” Professor Ferson said.

“There’s a number of ongoing community education and media campaigns to remind people of the importance of safe sex, of the diseases being around, the importance of testing, and those messages are going to doctors as well as members of the community.”

Professor Ferson said he can only speculate as to the reason behind the rising rate of gonorrhea throat infections among gay men, as the database only provided minimal background information about patients.

“We presume [the cases] are largely men who have sex with men, but that’s an assumption that will be confirmed when we do this additional surveillance."

The next stage of the study will involve contacting doctors to request information about the reasons for the initial STI test, what sexual behaviour the patient admitted to and their sexual preference.

CEO for sexual health organisation, ACON, Nicolas Parkhill, agreed the reasons behind the increased rates of infections would be speculative.

“However, it is reasonable to suggest that gonorrhoea rates are likely to reflect a combination of the level of sexual activity in a population, variations in people’s understanding of safe sex practices, and the infectious nature of the bacteria,” he said.

“These factors, when combined with variations in how often health services offer tests, are likely to be factors that contribute to the rise in infections.”

Mr Parkhill said persistence and reinforcement of messages about safe sex practices is important as “behaviour change and healthy behaviours are sometimes difficult to achieve across an entire population.”

He said all men who have sex with men should have at least one test per year, but men who have episodes of unprotected sex, or have more than 10 partners in six months, should have more frequent tests – at least every three to six months.